It pretty much is. Oh sure there is a little consumer pressure, but nothing like when you have free choice of any product.
The market for health insurance isn't the only relevant market. Profit incentive motivates a great deal of innovation in drugs, devices and procedures.
Even in the insurance market, companies have an incentive to contain the costs of the insurance products they subsidize for their employees in exchange for the employee services. At the other end insurance companies have an incentive to control the costs of procedures. Does it work as well as if the consumer was cutting the check themselves? No. In some cases it works almost as well, in some cases it isn't even close, but even in those cases it doesn't mean there is no benefit from market forces, just less benefit.
re: Than apparently it isn't single payer, and providers have to fill out forms for different insurance companies, but you where counting on so much savings from economies of scale on the insurance company side, and only having to deal with one insurance organization (the federal government) on the health care provider side.
In rare cases not in every case. And just for the 'ups and extras'. My guess is that it would be paid by the end user and reembursed by the insurance company. The provider might not even be involved.
It is of course possible that the user of the services could pay and than be reimbursed by the insurance company, but that is by no means a given, and its also something that's possible in our current system. The main reason its not a lot more common is that people usually don't want to have to float the cost before getting reimbursed.
And the issue isn't just with highly specialized "ups and extras", but rather with coverage a lot of people are going to want, unless the basic coverage is surprisingly lavish. And if it is so lavish, there goes your plan for lowering costs. |
